Please answer - heart beats

[mj124ca]

34 years male, overweight, 5-11'' and 227 pounds. lost about 50 pounds. I have been experiencing irregular heart beat for the past 3 years. Sometimes, it feels that the heart is going to stop and I do get diziness for a "micro" second. see

CT Angio: Mild (less than 50%) stenosis in the proximal and mid LAD due to non calcific plaque. Mild Stenosis (less than 50%) in the distal LAD due to calcific and non calcific plaque

Holter and Event Recorder: PVC, I was told there is nothing serious

Echocardiogram: Normal but showed the RV systolic function little bit reduced and asked for a MRI. LV is completley normal.

Extensive Blood Work:
Chesltrol = 151
Triglycerides = 92
HDL = 55
LDL = 78
Homocysteine = 10 umol/L
LP(a) = 0.11 g/l
hs-CRP = done twice, first it was 3.3 than 6.4 mg/l
EKG = normal
Normal-high BP (138/79)
I do not smoke at all. no alcohol and no drugs whatsoever. I do take the following supplements on daily basis:
-baby aspirin
-fish oil 4000mg
-CoQ10 125mg
-Magnesium 100mj
-multivitamin

Father has pacemaker and mother has HBP. I exercise regularly. The other day I was at the gym and was engaged in a group exercise class and almost fainted (I was well hydrated though). Also, the same night, I experienced irregular pounding heart beat after sexual intercourse. Also, during sessions of masturbation, I experience irregular heart beat. I was wondering if you could comment on my condition. I am really concerned about my condition.

I have chronic prostatis and I believe that it might be contributing  to it.
Is there any way to reverse the plaque in my arteries?
Do I have significant plaques?
Can this plaque be causing all of these symptoms?
What kind of risk I have for stroke or heart attack (low, medium, high)?
Can masturbation cause sudden heart stop due to adrenaline (SAD?)?
If I loose weight, will it help my heart condition?
Should i be taking stains (to even further lower LDL and hs-crp)?

[mj124ca]

Thanks Doc. Few more questions

CRP level are high and even if I loose weight and diet/excercise, can it still advance the plaque? I am hoping the level will actually go down with weight loss


The level of stenosis I have, is it a very common thing in overwieght people?


I thought that the CT angiogram aslo provided the score (agatstone scoor) for soft and hard plaque combined? Mine did not, Am i missing something?


How can I monitor the plaque progress in future? I am concerned about radiations (considering I am 34 yeras old). When should it be repeated or can Cardiac MRI be used instead?


Any comments on my Chlestrol numbers (total, HDL, LDL) and hs-crp? It looks like that my cardiologist might put me on Statins. Another cardiologist told me to loose weight, excercise and eat well (midterian diet)


Thanks,

[Michael J. McWilliams, M.D.]

Is there any way to reverse the plaque in my arteries?

The jury is still out on this one.  There is data that high dose lipator will reverse plaque burden but not by much.  With your doctors approval, the best thing you can do is continue to lose weight, exercise and eat right.

Do I have significant plaques?

You have plaques and you are young.  I would take this as a warning and focus on positive changes like diet ad exercise.

Can this plaque be causing all of these symptoms?

Probably not. It would take a heart monitor to determine if there is an abnormal heart arrhythmia involved, more than just PVCs that is.  It is unlikely.

What kind of risk I have for stroke or heart attack (low, medium, high)?

You risk is probably higher than average because you are overweight and you have known plaque on CT scan.  By using the Framingham risk calculator, your 10 year risk is less than 1%.  You have some no traditional risk factors that are not included in the risk score.

My advice is to enact positive change like continuing to lose weight, exercise and eat right.  Stop eating after 6 pm, especially before bed.  Don't drink soda with sugar.  There are many ways to skin (sorry to offend cat lovers) but the important thing is to stay positive and enact positive changes to your lifestyle.

Can masturbation cause sudden heart stop due to adrenaline (SAD?)?

I have seen a patient that goes into atrial fib with sexual intercourse and masterbation.  It can affect heart rhythm.  It would require a heart monitor to determine if there is achange in your heart rhythm.

If I loose weight, will it help my heart condition?

Probably, as long as you do it the right way -- no fad diets.

Should i be taking stains (to even further lower LDL and hs-crp)?

That is a tough call.  The ablsolute risk reduction in patients with risk factors for CAD and no previous MI is only 1%.  Some people do it but I don't think there is a consensus.

I hope this helps.  Thanks for posting.